135例艾滋病免费抗反转录病毒治疗病例失访原因分析

An analysis on reasons for loss to follow-up in 135 AIDS patients receiving national free antiretroviral therapy

目的了解艾滋病免费抗病毒治疗(ART)病例的失访原因,为提高免费ART效果提供支持。方法回顾性分析2005-2014年在北京佑安医院性病艾滋病门诊接受国家免费ART后失访的病例,分析其失访时接受ART的时间,打电话联系了解其失访的原因。结果 2005-2014年,在北京佑安医院性病艾滋病门诊接受国家免费抗病毒治疗的病例共2482例,失访135例(5.4%)。失访病例中55例(40.7%)在治疗6个月内失访,20例(14.8%)在治疗6-12个月失访,35例(25.9%)在治疗12-24个月内失访,有25例(18.5%)在治疗24个月后失访。32例(23.7%)因联系方式变更无法知道失访原因,42例(31.1%)因不良反应失访,13例(9.6%)因个人赴外地工作生活失访,12例(8.9%)因改服中药失访,10例(7.4%)担心暴露身份而失访,9例(6.7%)因经济状况差无法承担自费化验失访(其中5例经电话联系,在失访4个月后重新开始治疗),8例(5.9%)因对医务人员服务态度不满意失访,6例(4.4%)死亡,3例(2.2%)因对治疗信心不足失访。结论接受免费艾滋病ART的病例失访原因多样,需要加强干预,以提高抗病毒治疗的整体成功率。

Objective To study the reasons for loss to follow-up in acquired immunodeficiency syndrome （AIDS） patients receiving national free antiretroviral therapy （ART） and provide support for improving effects of the free ART. Methods A retrospective study was conducted on HIV infected patients loss to follow up after receiving na- tional free ART. The time to loss to follow-up after the initiation of ART and the reasons for loss to follow up were analyzed. Results Among 2482 patients receiving national free ART from January 2005 to January 2014, 135 （5.4%） were lost to follow-up, among which 55 （40.70%） were lost to follow-up within 6 months after the initia- tion of ART, 20 （14.8%6） were lost to follow-up between 6 to 12 months, 35 （25.9%） were lost to follow-up be- tween 12 to 24 months, and 25 （18.5%） were lost to follow-up after 24 months of ART. Reasons for loss to follow- up were unknown in 32 cases （23.7 %） because of invalid contact information. Among the rest patients loss to fol- low-up, 42 （31.1%） were lost due to adverse effects, 13 （9.6%） due to moving to other cities, 12 （8.9%o） clue to switching to traditional Chinese medicine, 10 （7.4 %） due to worrying about exposure of identity, 9 （6.7 %） due to poor economical status, 8 （5.9%） due to unsatisfying with medical service, 6 （4.40%） due to death, and 3 （2.5%） due to lacking confidence on therapy. Conclusion The reasons for loss to follow up in patiets with national free ART were various. Interventions should be intensified for better outcomes.